[Extrapulmonary tuberculosis in a patient with septic shock].

Area of Science:

• Microbiology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Extrapulmonary tuberculosis (TB) diagnosis is challenging, especially with negative cultures.
• Staphylococcus aureus sepsis can present with osteomyelitis and skin lesions.
• Microscopic examination may miss certain acid-fast bacilli.

Observation:

• A patient with Staphylococcus aureus sepsis developed vertebral osteomyelitis and skin lesions.
• Skin biopsy revealed alcohol-resistant acid-fast bacilli.
• Polymerase chain reaction (PCR) testing was positive for Mycobacterium tuberculosis DNA in skin and spinal samples.

Findings:

• PCR assays demonstrated higher sensitivity than microscopy for detecting Mycobacterium tuberculosis.
• PCR provided a diagnosis within 24 hours, outperforming traditional culture methods.
• The study highlights the utility of PCR in diagnosing extrapulmonary TB.

Implications:

• Rapid molecular diagnostics like PCR are crucial for timely and accurate diagnosis of extrapulmonary TB.
• PCR can overcome limitations of microscopy and culture in diagnosing M. tuberculosis infections.
• This approach improves patient management for complex TB cases.